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Organ Failure Complications Hepatorenal syndrome (renal failure) Decreased urine output Labs show elevated creatinine Admit to hospital (high mortality) Hepatic encephalopathy (brain failure) Introduction Liver clears ammonia from body In advanced liver failure, ammonia increases Symptoms Altered mental status/confusion Asterixis Treatment Lactulose Binds ammonia and is excreted Rifaximin Eliminates bacteria responsible for producing ammonia Portal […]

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Non-Accidental Trauma Estimated 10% of pediatric patients are victims of abuse Sexual abuse Physical abuse Neglect Common red flags Changing story Story that doesn’t make since Delays in seeking care Unusual bruising locations Torso Ears Neck Common tests if non-accidental trauma suspected Skeletal survey x-rays Head CT Especially if altered mental status Abdominal CT Especially […]

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Don’t be overwhelmed knowing/memorizing each inborn error of metabolism. The basic approach is actually quite easy!!! Inborn Errors of Metabolism (IEM) Almost always result in one of the following three clinical abnormalities Buildup of toxins Ammonia To test for this, obtain an ammonia level Buildup of acids Methylmalonic acidemia To test for this, obtain electrolyte […]

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Common Chief Complaints Cyanosis Difficulty feeding Failure to thrive Cyanotic Heart Lesions Truncus arteriosus Aorta and pulmonary artery are fused Single vessel comes from both ventricles Transposition of great vessels Aorta comes off RIGHT ventricle Pulmonary artery comes off LEFT ventricle Tricuspid atresia Blood unable to get from right atrium to right ventricle Tetrology of […]